Permit CITY OF TIGARD MASTER PERMIT
ss COMMUNITY DEVELOPMENT Permit#: MST2006-00159
Date Issued: /20
07/1406
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Parcel: 7 14/20 01600
/4 45 Jurisdiction: TIG
Site address: 7405 SW BEVELAND RD
Subdivision: Lot:
Project: SPAAN
Project Description: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
wiring. 2/19/2015: REPRINT permit to reinstate for final inspections.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: First: sf Basement: sf Left: Parking Spaces: 2
Height: Bathrooms: Second: sf Garage: sf Front: Smoke
Yes
Dwelling Units: Third: sf Right:
Detectors.
Total: sf Value: $20.000 00 Rear:
PLUMBING
Sinks: Water Closets: Washing Mach: Laundry Trays: Rain Drain: Urinals:
Lavatories: Dishwashers: Floor Drains: Sewer Lines: SF Rain Storm Sewer:
Tubs/Showers: Garbage Disp: Water Heaters: Water Lines: Drains: Catch Basins:
Bckflw Prevntr:
Footing Drain: Ice Maker: Hose Bib: Backwater Value:
Other Fixtures: 1
Drywell-Trench Drain:
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: Clothes Dryers.
Heat Pump: N Hoods: Other Units.
Furn<100K: Vents: Woodstoves: Gas Outlets:
Furn>=100K.
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 0-200 amp: 1 0-200 amp: W/Svc or Fdr: 1
Ea add'l 500 sf: 201-400 amp: 201-400 amp: W/O Svc/Fdr:
Mfd Home/Feeder/Svc: 401-600 amp: 401-600 amp:
601-1000 amp: 601+amp-1000v:
1000+amp/volt:
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description:
Ecompasing: N
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
ADD SF 5N R3
Owner: Contractor:
HARLOW SPAAN,JEFF SORG,CONI MEREDS ELECTRIC CO INC Required Items and Reports(Conditions)
7405 SW BEVELAND RD 2002 SE CLINTON ST
TIGARD,OR 97223 PORTLAND,OR 97202-2245
PHONE: 503-636-4580 PHONE: 503-233-6467
FAX: 503-233-1281
Total Fees: $774.58
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 throug OAR 952-001-Os 0. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232119887 or 1.800.332.2344.
/It 1,7Z—•1/4 /
Issued By: ' . • -
- - Permittee Signature: e7� ' O/\/
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
l
MA PERMIT
C ITY TIGARD PERMIT #: MST2006 -00159
~,- , DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
4 II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AB -01600
SITE ADDRESS: 07405 SW BEVELAND RD ZONING:
SUBDIVISION: HERMOSO PARK LOT: 018 JURISDICTION: TIG
Project Description: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: THD: sf RIGHT:
VALUE: 20
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOIL/CMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS:
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC/FOR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM/SVC /FDR: 601 - 1000 amp: 601 +amps -1000v MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
> =4 RES UNITS: SVC /FDR > =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SY AUDIO & STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: •TH: DATA BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the
Owner: Contractor: Tigard Muniapal Code, State of OR. Specialty Codes
HARLOW SPAAN, JEFF SORG, CONI I OWNER and all other applicable laws. All work will be done in
7405 SW BEVELAND RD accordance with approved plans. This permit will expire
TIGARD, OR 97223 if work is not started within 180 days of issuance, or if the
work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules
Phone: 503 -636 -4580 Contact #: adopted by the Oregon Utility Notification Center. Those
rules are set forth in OAR 952 - 001 -0010 through
952 - 001 -0080. You may obtain copies of these rules or
Reg #: dired questions to OUNC by calling 503 - 246 -6699 or
TOTAL FEES: $ 738.58 1 -800- 332 -2344.
REQUIRED ITEMS AND REPORTS ■
Issued By . :0� -11��� Permittee Signatur c�. G� f�
Call 503 - 639 -4175 by 7:00 a.m. for an inspection t at business da
Y Pe day.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2006 -00159
�li�l ,. DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
` _ --- 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171
PARCEL: 2S 101 AB -01600
SITE ADDRESS: 07405 SW BEVELAND RD ZONING:
SUBDIVISION: HERMOSO PARK LOT: 018 JURISDICTION: TIG
Project Description: Convert garage to habitable space and upper floor remodel.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 20,000.00 REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOILCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: ( ,
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 • 200 amp: 1 0 • 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 • 400 amp: 201 - 400 amp: 1st W/O SVC/FDR: SIGN /OUT LIN LT: PER HOUR: (f )
LIMITED ENERGY: 401 • 600 amp: 401 • 600 amp: EA ADDL BR CIR: SIGNAL/PANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601 +amps- 1000v: MINOR LABEL:
1000+ amp/volt : fO
PLAN REVIEW SECTION O
. . Reconnect only:
>=4 RES UNITS: SVC /FDR> =225 A.: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL • RESTRICTED ENERGY G
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO 8 STEREO: FIRE ALARM: INTERCOM/PAGING: OUTDOOR LNDSC LT:
0
BURGLAR ALARM: 0TH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: NURSE CALLS: TOTAL 6 SYSTEMS: tin
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
HARLOW SPAAN, JEFF SORG, CONI MEYEF applicable laws. All work will be done in accordance with approved
7405 SW BEVELAND RD plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97223 of issuance, or if the work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through 952- 001 -0080. You may obtain copies
Phone: 503 -636 -4580 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Reg #:
TOTAL FEES: $ 657.58
REQUIRED ITEMS AND REPORTS
Issued By : A P!, . _ ,A _,/% Permittee Signature • ■, /I4
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr ject.
Approved plans are required on the job site at the time of each inspection.
INSPECTOR'S SIGNATURES ARE NOT
Inspections Required for: MST2006 -00159 REQUIRED ON GREEN INSPECTION CARD.
✓ I Code I Inspection Description I PASS Date By
: By I
MST - Master Permit
405 Excavation
_ 410 Fill
415 Grading
X 205 Footing �l1 '_� �,r]Q � y'^ 18- 04 k) -- -
805 MFG - Structure y r ding/footing
X 210 Foundation walls ` •
215 Footing drain
.; i ii \
305 Plumbing underslab
105 Undcrground/slab cover � '
220 Slab ` 1 1
, , f i
310 Crawl drain /
315 Post/beam plumbing
605 Post/beam mechanical
225 Post/beam structural `
230 Underfloor insulation f 1110 i
235 Shear walls /anchors iP' ►
X 240 Exterior sheathing ` �
242 Interior shear walls )
101: 245 Firewall
250 Roof nailing 1 255 Wtr proofing basement walls 1
_ 265 Masonry
270 Reinforcing steel (rebar)
X 320 Plumbing rough-in
322 Shower pan Cvelt
610 _ Gas line `
X 615 Mechanical rough in i4-jki
110 Temporary electrical service ` ;. 4
_______ 3_1 ( .. :______C 4
X 115 Electrical service Q•Z('Olb I ( , �'� ,
X 120 Electrical rough -in JO 'S • o4 ��1.M
135 Low voltage ,
910 Sprinkler rough -in
X 275 Framing qi (e D i , k6T47 '"Tf
aa,lera
810 MFG - Structure set -up
X 280 Insulation i b/ /6(p 4
330 Water service _
335 Rain drain
340 Storm drain
, 505 Sanitary sewer
350 Septic tank n`` _(
285 Drywall nailing L C4—A ,--1.}.J-,-,11 b /
289 Approach/sidewalk 1 / �
295 Misc. inspection:
899 MFG - Structure final
498 Grading final
X 699 Mechanical final
X 399 Plumbing final
X 199 Electrical final
X 299 Final inspection
I: \Building \Inspection Cards`•.Fonns \MST- JnspCard- Blank.doc 12,09/2005
I f 0 S
February 5, 2008
Property Owners
7405 SW Beveland Rd
Tigard OR 97223
RE: Permit MSTMST2006 -00159
This letter is notification that the referenced permit for the work at the above address has not
received a final inspection. Since more than six months has elapsed with no inspection activity, it is
assumed that °the work has eitherbeen suspended �r abandoned and this permit will be . expired by
limitation as provided in Section R105:5 of the Oregon One & Two Family Dwelling Specialty
Code.
Please be advised that, in the event of a subsequent sale of your home, the lack of inspection
approval for this permit could delay closing. The lending institution and /or the -title company may
require proof of a completed permit for such work prior to the sale of the property.
We will allow thirty (30) days from the date of this letter to apply for reinstatement of this permit for
the purpose of final inspection(s). Certain fees will be applicable at the time of reinstatement.
A reinstated permit will be valid for 30 days. If the required inspection(s) fails, you will have an
additional 30 days to make the necessary corrections.. A •m nimuni.:fee.of $70.00 will be assessed for
additional inspection(s). If you fail to request these additional inspection(s), this permit will be
expired without the opportunity for reinstatement.
If you have any questions about the permit or its status, please call Jeanne Temple in our office at
503 - 718 -2433, Monday- Friday, 7:00 a.m. to 3:00 p.m.
Sincerely,
Darrel "Hap" Watkins
Inspection Supervisor
cc: Property File
•
Sep. 13. 2006 9:23AM 1 : r r , No. 0543 P. 1/2
Electr Y ermit Ap li g
City of Tigard
. `i g Date/e / _ • " / .''. y . Permit No- � J 5Q
13125 SW Hall Blvd„ Tigard, OR 97223 SEP -i ply Retie (� V 7
Phone; 503.639.4171 Fax 503.598.1960 SCf ' �� "' • t J i l b . Other Permit;
Inspection Line: 503.639.4175 _
Date Ready/By. �' 65 See Page 2 for
Internet: www- ci,tigard.or.us N
Li Y Or i� iu CiaC �.i ) supplemental information
•
• ; w :� ' 'r r c4,� we, s• is � � ..‘' •`• l�irY•i ' �,•�x, link 'i, :: , t n - • ;Ni '.4;t-1 U.Ta ; e. h' �. •�•• ',� r W, •, f y 4 RkK x: :f' : o s M' , 'e :
..,� :r ".. , ,,.s :: ���r,..� ai�• � . 8� !' f- , n�. ` �.�� „�.., : :,�P-.. �4 ' ..,�'1°�•�j; �.t -f,,�!� <.4� : � �' I � , �: :Vy a r k y„ i�F
CI New construction Addition/alteration/replacement Please check all that apply:
❑ Demolition ef; ['Service over 225 amps, comae! ['Hazardous location
� i” ?,1 ti' r� rr a 1 p a . w. r . „ ❑$erica oVer 20 amps - rating piuildng over 10,000 sq. ll.,
.i'�'�, ' ' a � e a' XX 1� ^dd' �'l tiS'x �; nS %ca
.,., � , . R �t �,�. ' ........ 'r.; W /ir :,.. e .ls,; .., 51, 4 ,1 1M , ..W , '' > ; of I- and 2 family dwellings 4 or more new residential N 1- and 2- family dwelling ❑ Commercial/industrial 1:1 Accessory building • ['System over 600 volts nominal units in one structure
Multi family (] Manta builder [] Otter; ❑Building over three stories ❑ Peeders, 400 amps or more
"- C:'c. ti: - t• ;(i,y'. �:Z r.:<i � .' • • l,'pa' • . ' •: M�� t ,,0 „, :A
•..., „.... ['Occupant load over 99 persons ❑Manutictured structures or ,
^, _ ;�.� ;- ._ : ::sir ; : .��„ „ . !,.1.";!,v, ... _ .._ ., ?�'.4y ' . , . , ^, J. r,h:5 Vl`";� ; ?hi:.Y ['Egress/lighting plan RV park
Job no.: I Job site address: - 79 3 $ so 80,uelcuict ❑Health facility °Other:
Subm it 2 sets of plans with any of the above.
City /State/ZIP: The above are not applicable to temporary construction service. .
Suite/bldg. /apt.no.: Project name: G� . a 1 a' :.2r` is m ) ” :alai: y s!> :?, % %" e4 ,?, ; r
Description Qq I Yee I Total I
Cross street/directions to job site: New residential single- or multi - family dwelling unit.
Includes attached garage.
•
1,000sq. f, or less III 145,15 4
Subdivision: L no Ell add'l 500 sq. ft. or portion 33.40 0
Tax map/parcel no.: Limited energy. residential ■ ++ 1112 I
x ".Sc ,- ,Qy,,, � .,.� ,�,,,..- Limited energy, non- residential 75.00
• , � _ r.
: 1M: • , ': s"f7' I striate IYa � p „ , . , , Z , � J..1 •
`flair , fi P 4g r . cn a:, a ,, ,, 15., • i_ 1 Vn i. 7 Each manufactured or modular
•nu,-- ,.Nip. .a a . :,.
U (]a 1 1 f C dwi i4 service and dal . 90.90 ..... 2
P' i/ v '- Services or feeders installation, alteration, and/or relocation
200 amps or less / 80.30 1,; , 30 2
, "i . ,. , . ;r Ferri ' j r , • , i r$ t F 'ev,`a'” ( .),., i 201 amps to 400 amps 106,85 2
401 amps to 600 amps 160,60 • . 2
Name:
{/t-' (0 u ( . ) pa -04., v -- . 601 amps to 1,000 amps 240.60 2
Address: Over 1,000 amps or volts 454.65 2
Reconnect only 6615 2
Cit _ Temporary services or feeders installation, alteration, and /or
Phone: ('3) le, 3 ( -r y e Fax: ( ) relocation
f 200 amps or less 66.83 1 I 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 10030 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 600 amps 133.75 2
Owner signature: Date: .,/„ , � v m r" ,�mV, s+ m t.,� � � Breach circuits -new, alteration, or extension, per panel
M, ar rat) •� �i �,a �'` { xG f7 . .. r I ° I `1, M t `' ` „ " �• A F ee for branch circuits with
.3�,L u-,' , a � rw m . = sou , , �0 • service or [ceder fee, each l
Business name: branch'circuit 6.65 /1,95 2
B. Fee for branch circuits
Contact name; without service or feeder fee,
Address:
each branch Circuit 46.85 2
Each add•l branch circuit 6.65 2
City/State/ZIP: Mlseellaaeons (service or feeder not included)
Pump or irrigation circle s . 53.40 2
Phone:
( ) I Fax; ) Sign or outline lighting 53,40 • 2
E -mail:
Signal circuit(5)
r tom circuit(5) or limited-
. , _,. 1 .+ '- r M ? t c *Ol W�` t ^x;MA `a, , .t m, J .r , energy panel, alteration, or
extension. Describe: Page 2
$usiriesi Red' Electric Company _
. - Add 2002 SE Clinton Each additional inspection over allowable in any of the above
Portland, OR 97202 Per inspection 62.50
City /Sta (503)233 - 8467 Fax (503)233 - 1281 Investigation per hour (1 hr min) - 62.50 1111 •
• Phone::.( CCB# 4443 Elec. Llc# 26 - 152C Supry Lic.# 5010 - S Industrial plant per hour r4 — [p.
73.75 �-
�•CCl3 Lk .._�`i'�fa,.; ; ^.��'�t': r� ;i %c : :e..
Subtotal / "
Suprv. Electrician signature, required: "\ Plan review (25% of permit doe) .
�" , .. C Date: �/ / � State surcharge (8% of permit fee) r , a
Print name:
`-' rN F e V Y iJ ' ! /3 0, !'OTAL PERMIT FEE Da? A9.
Authorized signature: This permit application aspires Ira permit is not obtained Meade 180
I days after it bas been accepted as complete
Print name: Date: ' • Fee methodology set by Tri- County Building industry Service Board
• '• Number of inspections per penult allowed
isliulldinePo rmie \ELC•PmmilApp,doc 12103 41046157(1cmIcoz.owm
CITY OF TIGARD MASTER PERMIT
PERMIT #: MST2006 -00159
i
4111 DEVELOPMENT SERVICES DATE ISSUED: 7/14/2006
A II 13125 SW Hall Blvd., Tigard, OR 97223 503 - 639 -4171 PARCEL: 2S101 AB - 01600
SITE ADDRESS: 07405 SW BEVELAND RD ZONING:
SUBDIVISION: HERMOSO PARK LOT: 018 JURISDICTION: TIG
Project Description: Convert garage to habitable space and upper floor remodel.
BUILDING
REISSUE: CUSTOM STORIES: 2 FLOOR AREAS REQUIRED SETBACKS REQUIRED
CLASS OF WORK: ADD HEIGHT: FIRST: sf BASEMENT: sf LEFT: SMOKE DETECTORS: Y
TYPE OF USE: SF FLOOR LOAD: 50 SECOND: sf GARAGE: sf FRONT: PARKING SPACES : 2
TYPE OF CONST: 5N DWELLING UNITS: THIRD: sf RIGHT:
VALUE:
OCCUPANCY GRP: R3 BDRM: BATH: TOTAL: 0 sf 20,000.00 REAR:
PLUMBING
SINKS: WATER CLOSETS: WASHING MACH: LAUNDRY TRAYS: RAIN DRAIN: TRAPS:
LAVATORIES: DISHWASHERS: FLOOR DRAINS: SEWER LINES: SF RAIN DRAINS: CATCH BASINS:
TUB /SHOWERS: GARBAGE DISP: WATER HEATERS: WATER LINES: BCKFLW PREVNTR: GREASE TRAPS:
OTHER FIXTURES: 1
MECHANICAL
FUEL TYPES FURN < 100K: BOIUCMP < 3HP: VENT FANS: CLOTHES DRYER:
FURN > =100K: UNIT HEATERS: HOODS: OTHER UNITS: /
MAX INP: btu FLOOR FURNANCES: VENTS: WOODSTOVES: GAS OUTLETS:
ELECTRICAL
RESIDENTIAL UNIT SERVICE FEEDER TEMP SRVC /FEEDERS BRANCH CIRCUITS MISCELLANEOUS ADD'L INSPECTIONS
1000 SF OR LESS: 0 - 200 amp: 1 0 - 200 amp: W /SVC OR FDR: 1 PUMP /IRRIGATION: PER INSPECTION:
EA ADD'L 500SF: 201 - 400 amp: 201 - 400 amp: 1st W/O SVC /FDR: SIGN /OUT LIN LT: PER HOUR:
LIMITED ENERGY: 401 - 600 amp: 401 - 600 amp: EA ADDL BR CIR: SIGNAUPANEL: IN PLANT:
MANU HM /SVC /FDR: 601 - 1000 amp: 601•amps- 1000v: MINOR LABEL:
1000+ amp /volt :
PLAN REVIEW SECTION
Reconnect only:
>4 RES UNITS: SVC /FDR> =225 A: > 600 V NOMINAL: CLS AREA/SPC OCC:
ELECTRICAL - RESTRICTED ENERGY
A. SF RESIDENTIAL B. COMMERCIAL
AUDIO & STEREO: VACUUM SYSTEM: AUDIO & STEREO: FIRE ALARM: INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM: OTH: BOILER: HVAC: LANDSCAPE/IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER: CLOCK: INSTRUMENTATION: MEDICAL: OTHR:
HVAC: DATA/TELE COMM: X NURSE CALLS: TOTAL # SYSTEMS:
This permit is subject to the regulations contained in the Tigard
Owner: Contractor: Municipal Code, State of OR. Specialty Codes and all other
HARLOW SPAAN, JEFF SORG, CONI MEYEF applicable laws. All work will be done in accordance with approved
7405 SW BEVELAND RD plans. This permit will expire if work is not started within 180 days
TIGARD, OR 97223 of issuance, or if the work is suspended for more than 180 days.
ATTENTION: Oregon law requires you to follow rules adopted by
the Oregon Utility Notification Center. Those rules are set forth in
OAR 952 - 001 -0010 through 952 - 001 -0080. You may obtain copies
Phone: 503 636 - 4580 Contact #: of these rules or direct questions to OUNC by calling 503 - 246 -6699
or 1- 800 - 332 -2344.
Reg #:
TOTAL FEES: $ 657.58
REQUIRED ITEMS AND REPORTS
Issued By : Permittee Signature • ,ice //A
Call 503 - 639 -4175 by 7:00 a.m. for an inspection that business day.
This permit card shall be kept in a conspicuous place on the job site until completion of the pr .ect.
Approved plans are required on the job site at the time of each inspection.
V II i . ,,, . -1 I. . , • 14 e i ' - : i t 1
Built ing Permit
U FOR OFFICE USE ONLY
71 City of Tigard Date/B ea �� w Permit No.: i i i 01A
q 13125 SW Hall Blvd., Tigard, OR 97223 Plan Review
II • Phone: 503.639.4171 Fax: 50 �� 2006 Date/B , ; G _ Other Permit:
T I G n I: D Ins Line: 503.639.417 Date Ready/By: See Page 2 for
dal
Internet: www.tigard or.gov Notified/Method: Supplemental Information
;;I O ! t
TYPFF'OIT ° )1,.! / N REQUIRED DATA: 1- AND 2- FAMILY DWELLING
❑ New construction ❑ Demolition Permit fees* are based on the value of the work performed.
Indicate the value (rounded to the nearest dollar) of all
71,Addition /alteration/replacement ❑ Other: • equipment, materials, labor, overhead, and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application.
Valuation: $ � , -/ /� fl
® I- and 2- family dwelling Commercial /industrial r ' v fi si U v - -
❑ Accessory building ❑ Multi- family Number of bedrooms:
❑ Master builder ❑ Other: Number of bathrooms:
JOB SITE INFORMATION AND LOCATION Total number of floors:
Job site address: 74 5 LJ -�, /1 ! u New dwelling area: 5 ' 5 � square feet
T /.
City /State /ZIP: .� Zi. CAD— VG 2 Garage /carport area: square feet
Suite/bldg. /apt. no.: �-/' Project name: d Covered porch area: square feet
Cross street/directions to job site: Deck area: square feet
. 72 d TO $eT/ t l Other structure area: square feet
REQUIRED DATA: COMMERCIAL -USE CHECKLIST
Subdivision: Lot no.: Permit fees* are based on the value of the work performed.
Tax map /parcel no.: Indicate the value (rounded to the nearest dollar) of all
equipment, materials, labor, overhead, and the profit for the
DESCRIPTION OF WORK work indicated on this application.
r q t (-/ 43I t � Valuation $ � r-
TErz: '_ tr_ 9 (� .26�r rCl /tom Existing building area: _square feet
t .a-tA. EA �
� � 4 Z � S, New building area: square feet
r• • a a ER ❑ TENANT Number of stories:
N a _ _ - .i . ,rer 046 _,4_...• _ , Type of construction: •
Address: ?Y405 Sec) /3 SUdZ4» o Occupancy groups: �,�'r,
City /State /ZIP: 7 42 99 ZZ-f Existing:
Phone: (5D3 G � - yl S'D Fax: (f#3 ) 4 ?1 / c, /(•O New:
XAPPLICANT a CONTACT PERSON , NOTICE
Business name: nn
Si�YJ1�' � A./Die i�SCN IA `.'"/ All contractors and subcontractors are required to be
Contact name: pl., \ % I licensed with the Oregon Construction Contractors Board
• under ORS 701 and may be required to be licensed in the
Address: jurisdiction in which work is being performed. If the
City /State /ZIP: applicant is exempt from licensing, the following reasons
apply:
Phone: ( ) I Fax:: ( )
E -mail:
CONTRACTOR /
Business name: . O E BUILDING PERMIT FEES*
(Please refer to fee schedule)
Address: l5, .915 Structural plan review fee (or deposit):
City /State/ZIP:
FLS plan review fee (if applicable): �,.._---
Phone: ( ) Fax:( )
CCB lie.: Total fees due upon application:
Amount received: #/6(9 , c7
Authorized signature:
This permit application expires if a permit is not obtained
Print name: /440,49..fx, f I Date: l3 /0t/ 7 within 180 days after it has been accepted as complete.
• Fee methodology set by Tri- County Building Industry
Service Board. ��� / ��
I: \Building\Permits\BUP -TI- PermitApp.doc 03/23/06 440 -4613T(II /02 /COM/WEB) ' A O r (2 ?
A.
1.111,
Building Division
Plan Submittal Requirement Matrix
- r I G A a D Commercial & Multi -Family - New, Additions or Alterations
Type of Submittal # of Plans -
(Includes new, additions and alterations.) Required at
Submittal
•
Demolition Permit 2
(site plan required showing' location and square
footage of all buildings to be demolished)
Site Work •
(must include location of all accessible parking)
Plumbing (site utilities) 2
Building 1*
•
• • Fire Protection •System ' 1 • •2 ** 71 = .
Mechanical
•
Plumbing. (building fixtures) 2'
Electrical •
•
•
Plan review is dependent upon submittal of a completed application and plans.
•
After plan review approval, the Plans Examiner will contact the applicant to request
additional sets of plans for distribution purposes (for contractor, City of Tigard, Washington
County, and Tualatin Valley Fire •& Rescue).
* For ovei- the - counter commercial tenant improvements, submit 2 sets of plans.
** "New" fire protection systems require that plans bear the original seal of an
Oregon licensed fire °suppression engineer, or NICET level "3" technicians.
I: \Bull ding \Peimits \BUP- TI- PermitApp.doc 03/23/06
•
•
El Per mit App FOR OFFICE list: ONLY -
City of Tigard p B 7 p T M T �/ 66 -eol '
13125 S W H
i Permit No.:
�� 9 '
Plan Review
111 Other Permit:
P 503.6 g98 a Date/B .
TI Li /\ It I� Inspection L i n e: � � � � OR Date Ready/By: 1uris: 55 See Page 2 for
Internet: www.tigard- or.gov ,,fi�nn�, Notified/Method: Supplemental Information
I J PE OF PV C PLAN REVIEW
❑ New construction i _ Addition/alteration/replacement Please check all that apply (submit 2 sets of plans w /items checked below):
r L- '- -O ❑ Service or feeder 400 amps or more ❑ Building over three stories.
i.> 1� emolition 1 Ig tit . d _ , - ^ 4 �� where the available fault current ❑ Marinas and boatyards.
A F CONSTRUCTION . exceeds 10,000 amps at 150 volts or ❑ Floating buildings.
' " " ONWI`" less to ground, or exceeds 14,000 ❑ Commercial -use agricultural
- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building amps for all other installations. buildings.
❑ Multi - family ❑ Master builder ❑ Other: ❑ Fire pump. ❑ Installation of 75 KVA or
❑ Emergency system. larger separately derived system.
JOB SITE INFORMATION AND LOCATION ❑ Addition of new motor load of ❑ "A ", "E ", "l - ", "l - ",
•
Job no.: Job site address: ? 4'2'J C ' 100HP or more. occupancy.
❑ Six or more residential units. 0 Recreational vehicle parks.
City /State/ZIP: j 7CJ � 24 67‹ 7 9. 2- ; ❑ Health -care facilities. El Supply voltage for more than
'' ❑ Hazardous locations. 600 volts nominal.
Suite/bldg. /apt. no.: Project name: ❑ Service or feeder 600 amps or more.
FEE SCHEDULE
Cross street/directions to job site: - - ( Description I Qty. 1 Fee. I Total I •
New residential single- or multi- family dwelling unit.
Includes attached garage.
Subdivision: . . . Lot no.: 1,000 sq. ft. or less 145.15 4
Ea. add'I 500 sq. ft. or portion 33.40 1
Tax map /parcel no.: Limited energy, residential 75.00 2
DESCRIPTION OF WORK (with above sq. ft.)
Limited energy, multi - family 75.00 2
residential (with above sq. ft.)
Services or feeders installation, alteration, and /or relocation
200 amps or less / X 80.30 2
'PROPERTY OWNER I ❑ TENANT 201 amps to 400 amps 106.85 2
Name: i ie 4 e6?.til 6 -c ` - 1 iF .li�� 401 amps to 600 amps 160.60 2
601 amps to 1,000 amps 240.60 2
Address: f CJs ./ `� � ( ,/L;� ivy Over 1,000 amps or volts 454.65 2
City /State/ZIP: 6 4172, ' M � .-1 2.2....3 Temporary services or feeders installation, alteration, and /or
relocation
Phone: (c03)6 .. 4: ., (.,50 Fax: ( 651 — Iii 200 amps or less 66.85 1
Owner installation: This installation is being made on property that I own which is not 201 amps to 400 amps 100.30 2
intended for sale, lease, rent, or exchange, according to ORS 447, 449, 670, and 701. 401 amps to 599 amps 133.75 2
Owner signature: Date: Branch circuits – new, alteration, or extension, per panel
A. Fee for branch circuits with
PPLICANT ❑ CONTACT PERSON above service or feeder fee, /
�, , each branch circuit
/ 6.65 2
Business name: S/'/ /';✓ /1 B. Fee for branch circuits
Contact name: without service or feeder fee
first branch circuit 46.85 2
Address: Each add'I branch circuit 6.65 2
Miscellaneous (service or feeder not included)
City /State/ZIP: Each manufactured or modular
dwelling, service and/or feeder 90.90 2
Phone: ( ) Fax: : ( ) Reconnect only 66.85 2
E - mail: Pump or irrigation circle 53.40 2
A ONTRAC.TOR Sign or outline lighting 53.40 2
/i �j n Signal circuit(s) or limited -
Business name: l.f `� energy panel, alteration, or
Address: extension. Describe: Page 2 2
City / State/ZIP: Each additional inspection over allowable in any of the above
Per inspection 62.50
Phone: ( ) Fax: ( )
Investigation per hour (I hr min) 62.50
CCB Lic.: Electrical Lic.: Suprv. Lic.: Industrial plant per hour 73.75
ELECTRICAL PERMIT FEES
Suprv. Electrician signature, required: Subtotal:
Print name: Date:
Plan review (25% of permit fee):
State surcharge (8% of permit fee):
Authorized signature: TOTAL PERMIT FEE:
This permit application expires if a permit is not obtained within 180
Print name: Date: days after it has been accepted as complete.
• Number of inspections allowed per permit.
1:\ Building\ Pamits\ELC- PamitApp.doc 05/23/06 440-4615T(I I /05 /COM/WEB
. •
Electrical Permit Application - City of Tigard
Page 2 - Supplemental Information
LIMITED ENERGY PERMIT FEES:
RESIDENTIAL WORK ONLY: •
Fee for all residential systems combined .. $75.00
Check Type of Work Involved:
❑ Audio and Stereo Systems*
❑ Burglar Alarm
❑ Garage Door Opener*
p Heating, Ventilation and Air Conditioning System*
❑ Vacuum Systems*
❑ Other.
COMMERCIAL WORK ONLY:
Fee for each commercial $75.00
system
(SEE OAR 918 -2(f) -260)
Check Type of Work Involved:
❑ Audio and Stereo Systems
El Boiler Controls
❑ Clock Systems
❑ Data Telecommunication Installation
❑ Fire Alarm Installation
❑ HVAC
❑ Instrumentation
❑ Intercom and Paging Systems
❑ Landscape Irrigation Control*
❑ Medical
El Nurse Calls
❑ Outdoor Landscape Lighting*
❑ Protective Signaling
El Other
Total number of commercial systems:
*No licenses are required. Licenses are required
for all other installations
I:\ Building\Pmnits\ELC- PcmitApp.doc 03/23/06
, Mechanical Permit A �Il•cation_ . ,-- I OR (_)I Fl(,I tisl o\l
City of Tigard T-4 ,� L ] vit G. N_..! e B 7 3 D & f l Permit No.: t-(�T� n - - OG / .
n 13125 SW Hall Bl Tigard,'OR 97223 Plan Review
' C Phone: 503.639.4171 Fax: 503.598.1960 Date/By, Other Permit:
T 1 G n 1t D Inspection Line: 503.639.4175 JUL 1 I `� 2006 Date Ready/By: lugs:
Internet: www.ti d-or. ov J v Supplemental See Page 2 for
g� g Notified/Method: Supplemental Information
Ty OF 4 A ht(
� FI C TON COMMERCIAL FEE* SCHEDULE — USE CHECKLIST
❑ New construction kddition/alteration/replacement Mechanical permit fees' are based on the value of the work
performed. Indicate the value (rounded to the nearest dollar) of all
❑ Demolition ❑ Other: mechanical materials, equipment, labor, overhead, and profit.
•
CATEGORY OF CONSTRUCTION Value: $
� RESIDENTIAL EQUIPMENT / SYSTEMS FEES*
Yom`- and 2- family dwelling ❑ Commercial/industrial ❑ Accessory building
For special information use checklist.
❑ Multi - family ❑ Master builder ❑ Other:
Description I Qty. I Ea. I Total
JOB SITE INFORMATION AND LOCATION Heating/cooling
e(6/5 5?-e), n Air conditioning or heat pump
Job site address:
� , 7,1' `Z4' (requires site plan showing placement) 14.00
City /State /ZIP: - 726477 o/ G j 7 r3 Furnace 100,000 BTU (ducts/vents) 14.00
Y
Project tame: Furnace 100,000+ BTU (ducts/vents) 17.90
Suite/bldg. /apt. no.:
� Gas heat pump 14.00
Cross street /directions to job site: 7 Duct work 14.00
�+ `/ ff �� ` Hydronic hot water system 14.00
L; f <�Edl 4./ VA-e— J y� ! C"", ` ` Residential boiler (radiator or
�i hydronic) 14.00
Unit heaters (fuel -type, not electric),
in -wall, in -duct, suspended, etc. 10.00
Flue /vent for any of above 10.00
Subdivision: Lot no.:
Other: 10.00 _
Tax map /parcel no.: Other fuel appliances
- - DECRIPTION OF WORK Water heater 10.00
�/ Gas fireplace 10.00
f l k. e %TE 1 Flue vent for water heater or gas
fireplace 10.00
Log lighter (gas) 10.00
Wood/pellet stove 10.00
Wood fireplace/insert 10.00
›CCPROPERTY OWNER I ❑ TENANT Chimney /liner /flue/vent
O 10.00 Other: 10.00
Name: / € G , 5:44'1974i ,(- SU €b, 611X 1 / , Environmental exhaust and ventilation
Address: .?.#6).5"" S/2 , 2Lc2 1r/(O / ✓ Range hood/other kitchen
equipment 10.00
City /State/ZIP:176 ( 2/7 Clothes dryer exhaust 10.00
Single -duct exhaust (bathrooms,
Phone: (5-v9) 6 ; 3 6 ' -- Fax: (r 6 . - y/,‘ toilet compartments, utility rooms) 6.80
'-- APPLICANT 0 CONTACT PERSON Attic/crawlspace fans 10.00
Other: 10.00
Business name: S-,t-p 4 /17?-y21„,/ Fuel r m
PP g
Contact name: $5.40 for first four; $1.00 for each additional
Address: Furnace, etc.
Gas heat pump
City /State /ZIP: Wall /suspended/unit heater
Phone: ( ) Fax: : ( ) Water heater
Fireplace
E -mail:
Range
CONTRACTOR Barbecue
Business name: /
1 'UV' Clothes dryer (gas)
/ �� N
Other:
Address: MECHANICAL PERMIT FEES*
City /State/ZIP: Subtotal
Minimum permit fee ($72.50)
Phone: ( ) Fax: ( ) Plan review (25% of permit fee)
CCB lic.: State surcharge (8% of permit fee)
TOTAL PERMIT FEE
Authorized signature: This p ermit application expires if a permit is not obtained within 180
days after it has been accepted as complete.
Print name: Date: • Fee methodology set by Tri- County Building Industry Service Board
11 Building \PermitsVMEC- PerrnitApp.doc 04/06/06 440 .4617T(II /02/COM/WEB)
l I
Mechanical Permit Application - City of Tigard
Page 2 - Supplemental Information
Commercial Fee Schedule:
Total Valuation: Permit Fee:
$1.00 to $2,000.00 Minimum fee $72.50
$2,001.00 to $5,000.00 $72.50 for the first $2,000.00 and $2.30
for each additional $100.00 or fraction
thereof, to and including $5,000.00.
$5,001.00 to $10,000.00 $141.50 for the first $5,000.00 and
$1.80 for each additional $100.00 or
fraction thereof, to and including
$10,000.00.
$10,001.00 to $50,000.00 $231.50 for the first $10,000.00 and
$1.35 for each additional $100.00 or
fraction thereof, to and including
$50,000.00.
$50,001.00 to $100,000.00 $771.50 for the first $50,000.00 and
$1.25 for each additional $100.00 or
fraction thereof, to and including
$100,000.00. .. . ,
$100,000.01 and up $1,396.50 for the first $100,000.00 and •
$1.10 for each additional $100.00 or
fraction thereof.
Note: All new commercial buildings require 2 sets of plans.
1:\Building\Permits\MEC- PermitApp.doc 12/30/05 2
, Building Fixtures f f �' "-� . -
Plumbing Permit Apullca J FOR OFFICE USE ONLY ,
City of Tigard J 3, 2006 Received 7 5 6 ,10 . Permit No i - C u,
, 66/57
! Date/By.
a 13125 SW Hall Blvd., T ( � gard, OR 97223 Plan Review
9 Phone: 503.639.4171 ., 503.598.1960' Date/By. Other Permit No.:
f I G A IL I� Inspection Line: 503 1)5 O F 1 1 yy f -j Date Ready/By: uns Pi See Page 2 for
Internet: www.ti rITRTh T AE; 1AK' 4 Notified/Method Sup Information
TYPE OF WORK FEE* SCHEDULE .
❑ New construction ❑ Demolition For special information use checklist.
Description I Qty. I Ea. I Total
Addition /alteration /replacement ❑ Other: New 1 - 2 - family dwellings (includes 100 ft. for each utility connection)
CATEGORY.. OF CONSTRUCTION SFR (1) bath 249.20
1- and 2- family dwelling ❑ Commercial /industrial SFR (2) bath 350.00
❑ Accessory building ❑ Multi - family SFR (3) bath 399.00
Each additional bath/kitchen 45.00
❑ Master builder ❑ Other:
Fire sprinkler ( sq. ft.) Page 2
. JOB SITE INFORMATION AND LOCATION Site utilities
Job site address: .670 $ Zi e 9 i Catch basin or area drain 16.60
City /State /ZIP: -7-/�, � d‹ �- 2-3 Drywell, leach line, or trench drain 16.60
Suite/bldg. /apt. no.: I Project name: Footing drain (no. linear ft.: _ ) Page 2
Manufactured home utilities 110.00
Cross street/directions to job site:
Manholes 16.60
Rain drain connector 16.60
Sanitary sewer (no. linear ft.: ) Page 2
Storm sewer (no. linear ft.: ) Page 2
Subdivision: I Lot no.: Water service (no. linear ft.: ) Page 2
Fixture or item
Tax map /parcel no.: Absorption valve 16.60
DESCRWTION OF WORK . Backflow preventer Page 2
Backwater valve 16.60
Clothes washer 16.60
Dishwasher 16.60
Drinking fountain 16.60
PROPERTY • OWNER I ❑ TENANT Ejectors/sump 16.60 •
Name: Ji-nezte,(4) s J c f, SU/I -- Celt( ✓ Expansion tank 16.60
Address: 7 e)sl ,4 -/rPMt Fixture /sewer cap / 16.60
City /State /ZIP: "r/6,15145) 0. e 7-7 1 2 - Z Floor drain/floor sink/hub 16.60
Phone: / J 3•`
( 5 ) 6 ., L 5-ked Fax: (5 2?) ' „!, f6 Garbage disposal 16.60
Hose bib 16.60
A APPLICANT . ❑ CONTACT PERSON
��/�E � > n �„ Ice maker I 16.60
Business name: � Interceptor /grease trap 16.60
Contact name: Medical gas (value: $ ) Page 2
Address: Primer 16.60
City /State /ZIP: Roof drain (commercial) 16.60
Sink/basin/lavatory 16.60
Phone: ( ) I 1 ax: ( ) Tub /shower /shower pan 16.60
E -mail:
Urinal IX 16.60
, . CONTRACTOR Water closet 16.60
Business name: 'z (J� 1" Water heater 16.60
Address: Other:
Subtotal
City /State /ZIP: Minimum permit fee: $72.50
Phone: ( ) Fax: ( ) Residential backflow minimum permit fee: $36.25
CCB Lie.: Plumbing Lic. no.: Plan review (25% of permit fee)
State surcharge (8% of permit fee)
Authorized signature: TOTAL PERMIT FEE
Print name: I Date: This permit application expires if a permit is not obtained within
180 days after it has been accepted as complete.
"'Fie methodology set by Tri -County Building Industry Service Board.
1�\ Building \Pamits\PLMF- PamitApp.doc 04 /06/06 440 -4616T(10 /02/COM/WEB) 1 , / i �� . 1 0 � !I n N /l n � 1e o ,.
Plumbing Permit Application - City of Tigard
•
Page 2 - Supplemental Information
Fee Schedule: Residential Fire Suppression Systems:
Site Utilities • . Qtr. Fee (ea) Total Square Footage: Permit Fee:
Footing drain - I a 100' 55.00 0 to 2,000 $115.00
Footing drain - each additional 100' 46.40 2,001 to 3,600 $160.00
3,601 to 7,200 $220.00
Sewer - 1st 100' 55.00
7,201 and greater $309.00
Sewer - each additional 100' 46.40
Water Service - 1st 100' 55.00 Medical Gas Systems:
Water Service - each additional 100' 46.40
Valuation: Permit Fee: .
Storm & Rain Drain - 1st 100' 55.00
$1.00 to $5,000.00 Minimum fee $72.50
Storm & Rain Drain - each additional 100' 46.40 $5,001.00 to $10,000.00 $72.50 for the first $5,000.00 and $1.52 for each
F or Item Qty F ee (ea) Total additional $100.00 or fraction thereof to and
including $10,000.00.
Commercial Back Flow Prevention Device 46.40 $10,001.00 to $25,000.00 $148.50 for the first $10,000.00 and $1.54 for
Residential Backflow Prevention Device each additional $100.00 or fraction thereof to
(minimum permit fee $36.25) 27.55 and including $25,000.00.
Rain Drain, single family dwelling 65.25 $25,001.00 to $50,000.00 $379.50 for the first $25,000.00 and $1.45 for
each additional $100.00 or fraction thereof, to
Inspection of existing plumbing or
and including $50,000.00.
specially requested inspections - per hour 72.50
Subtotal: $50,001.00 and up $742.00 for the first $50,000.00 and $1.20 for
ea additional $100.00 or fraction thereof.
Fixture Work: Plan Review for Complex Structures
Are you capping, adding or replacing fixtures? If "yes", A "complex structure" is defined as an installation of a plumbing
please indicate work performed by fixture. Failure to system that meets any of the following criteria.
accurately report fixtures could result in increased sewer fees *. Please check all that apply.
Quantity by (Fixture) Work Performed ❑ Any new commercial building.
Fixture Type: Replace ❑ Any new exterior plumbing site utilities.
Previous Capped Added Existing ❑ A commercial building with installation, alteration or addition
Baptistry/Font of nine (9) or more new or relocated plumbing fixtures.
Bath - Tub /Shower ❑ Medical gas and vacuum systems for health care facilities
- Jacuzzi/Whirlpool providing services to human beings.
Car Wash - Each Stall ❑ Plumbing installations, alterations or additions to food service
- Drive TIT, facilities where new plumbing fixtures, including interceptors,
Cuspidor/Water Aspirator'. are being installed for the food service area.
Dishwasher - Commercial ❑ Any new residential building containing three (3) or more
- Domestic dwelling units.
Drinking Fountain
❑ Any NFPA 13 - D multipurpose fire sprinkler system.
Eye Wash
Floor Drain /sink - 2" Submit 2 sets of plans with any of the above.
-3"
Car Wash Drain Isometric or Riser Diagram
Garbage - Domestic ❑ Isometric or riser diagram is required for new buildings
Disposal - Commercial three (3) or more stories in height.
- Industrial
Ice Mach./Refrig. Drains
Oil Separator (Gas Station) Comments regarding fixture work:
Rec. Vehicle Dump Station
Shower -Gang
-Stall
Sink - Bar/Lavatory
- Bradley
- Commercial
- Service
Swimming Pool Filter
Washer - Clothes *Note: If the fixture work under this permit results in an
Water Extractor
Water Closet - Toilet increase of sewer EDUs, a sewer permit will be issued and
Urinal fees assessed for the sewer increase must be paid before the
Other Fixtures: plumbing permit can be issued.
•
i.\ Building \Permits \PLM- PermitApp.doc 07/06/05
Permit #: IM' ¶ c 00& - Do 1 S9
Address: 7I05 cu.) E6V6 L 1 r
Issued by: Date: )( 7 /'f �
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2, and either box 3A or 3B:
_, S►� ri I. I own, reside in, or will reside in the completed structure.
2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
3A. My general contractor is
(Name) Contractor regis. #
= I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
- 3B. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
• registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to Property Owners about Construction Responsibilities on the reverse side of this form.
(Signature o ermit applicant) (Date)
(White copy to issuing agency permit . file,
pink copy to applicant)
•
llnformationl Notice to Property Owners
About Construction Responsibilities
Note: This h formation Notice to Property Owners about Construction Responsibilities
was developed by the Construction Contractors Board in accordance with ORS 701.055(?).
If you are acting as your own contractor to construct a new home or make a substantial improvement to an existing structure,
you can prevent many problems by being aware of the following responsibilities and areas of concern.
EMPLOYER PLOYER RESPONSIBILITIES:
If you hire persons not registered with the Construction Contractors Board to do labor in constructing or assisting in the
construction or improvement of a residential structure, you will, in most instances, be ruled to be an employer and the people
you hire will be employees. As the employer, you must comply with the following:
Oregon's withholding tax law: As an employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable for the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091.
Unemployment insurance tax: As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. For more information, call the Oregon Employment Department at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and must
obtain workers' compensation insurance for your employees. If you fail to obtain workers' compensation insurance, you ntay'
be subject to penalties and will he liable for all claim costs ifone of your employees is injured on the job. For more information, .
call the Workers' Compensation Division at the Department of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even i fyou didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1 -800- 829 - 1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see i fyou have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work ofrough-in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (P0 Box 14140, Salem, OR 97309 -5052,
503/378 - 4621). The Board is located at 700 Summer St. NE Suite 700. in Salem.
prop- owu.pm4
1/94
•
•
JUL Cc, l,.
,I,C 0 CITY OF TIGARD
RESIDENTIAL PERMIT APPLICATION REVIEW Pr1T tell OREGON
Permit Number • r r `r
Lot No.
llhdi ',toil
\ ddres - C
c:o)),tact N:,mc 14 AA, bt,J Sedan
Strut 1LAh5 fie(
G State d• Zip /
As required by the 1999 Legislative action (Senate Bill 587), your residential permit application
and plans have been reviewed to determine if it is complete and if the plans are deemed
"simple" or "complex" as defined in ORS 455.467 and 455.469.
The application is complete.
The application is incomplete for the following reason:
I The submitted plans will be reviewed; however, a permit cannot be issued until the
above information is reviewed and /or approved.
The submitted plans cannot be reviewed until the above information has been
submitted and /or approved.
The plans are deemed "simple ". The plans are deemed "complex ".
If you have any questions please call Loraine Williams at (503) 718 -2708.
Name of Plans Reviewer Date
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 TDD (503) 684 -2772
1 I
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00155
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639-4171
Inspection Requests (24 Hrs.): (503) 639 -4175 ,70
. .
INSPECTION WORKSHEET FOR DATE: 10/5/2005 TIME: 7:00AM PAGE: 42
SITE ADDRESS: 07405 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: _ HERI IOSO PARK LOT #: 010 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 0/15/06, adding low voltage for data
wiring. •-•
OWNER: HARLOW SPAAN, JEFF SORG, CONI I IEYER, PHONE #: 503-535 -4550
CONTRACTOR: Q PHONE #:
Inspection Request Scheduled For: Date: 10/=/2005 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 037737 -01 503 - 233-£7 N
Corrections /Comments /Instructions: `�
es 0 E JAo 14 P∎MSI - IN+ L-- C.i ®-v1 S �+
^ N. IL "
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Z k t Date: 0 NO Phone #: (503) 718 - 1 4 (4A1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: IST2006-00153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639 -4171
' Inspection Requests (24 Hrs.): (503) 639 -4175 s ' `'' I..
INSPECTION WORKSHEET FOR DATE: 10/2/2006 TIME: 7:03AM PAGE: 36
SITE ADDRESS: 07406 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 018 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 6/15/06, adding low voltage for data
wring.
OWNER: HARLOW SPAAN, JEFF SORG, CONI MEYER, PHONE #: 503 -636 -4580
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 10/2/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
120 Electrical rough -in 037493-01 503 - 233 -6467 N
Corrections /Comments /Instructions:
0 OA cep a , cbU VA offs f'NL p071401
ti 6I& .. pl�T5 \yam C N k 4 & o 0 ; A ) s0`7 cue yy-
,A-E . 6 l \ Zi a.ve F
€.0,eek. kid.- To P 4 W IA .,
1,. _ , s ,
iv kb, ti,.. 6.:. .ft, ....■'• 4. _
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‘ \ c An T itrallaVEN9111 1 AVIll 1
N . N 1 M ,-
NCB = -S v o► c ..6a4 c 'i N
toWm644.)
❑ PASS 'PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: 68 L 'V Date: I a ' 2. o1/4) P hone #: (503) 718- 2ligb
CITY OF TIGARD
BUILDING DIVISION PERMIT #: M t"2006 -00I ;S
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/7006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 � ° 'I �..
INSPECTION WORKSHEET FOR DATE: 900/2006 TIME: 7:01AM PAGE: 45
SITE ADDRESS: 07405 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 0 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
wiring. •
OWNER: HARLOW SPAAN, JEFF SORO, CONI MEYER, PHONE #: 503 - 636 -4580
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9 /20/7006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
115 Electrical service 036854 -01 503-233-6467 V
Corrections/Comments/Instructions:
CAcc- . ' Zap J 10 coLz tAIA /za, ON ao 14-& .
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
n FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED ,
Inspector: v ---- Actt. 1') L Date: 91 C% Phone #: (503) 718- 101'
CITY OF TIGARD
BUILDING DIVISION PERMIT #:
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: MST2006 - 00153
Phone: (503) 639 - 4171 f�l� 7/
Inspection Requests (24 Hrs.): (503) 639 -4175 � .�
INSPECTION WORKSHEET FOR DATE: TIME: PAGE:
81 7M 63
SITE ADDRESS: CLASS OF WORK:
SUBDIVISION: 0 7 4 0 5 SW BF_VELAND RD LOT #: TYPE OF USE:
PROJECT NAME: HERMOSO PARK 018 2 _.0 7-
DESCRIPTION: SPAAN
Convert garage to habitable space and upper floor remodel.
OWNER: PHONE #:
CONTRACTOR: HARLOW SPAAN, JEFF SORG, CONI MEYER, PHONE #: 50636,4590
Inspection Request Scheduled For: Date: 81 Pour Time:
Code # Inspection Description Confirm #14�2t106 Contact # Message
120 Electrical rough -in 034876-0/ 503 - 636-4500 N
Corrections /Comments/ Instructions:
•O PU 0 v . cc r e.,,,,, 4- / e1 . I
aG) P/, v +' - q Z.- V sLi%- (.44.1 f f l et 6e/
P I4-4- 949 Co Lfru2...,/
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: Date: e /Y- ` O6phone #: (503) 718- 1
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006.00168
13125 SW Hall Blvd., Tigard, OR 97223 D ATE ISSUED: 7/14/2006
Phone: (503) 639 - 4171 , 1
Inspection Requests (24 Hrs.): (503) 639 -4175 ,_'!!+� p'IJ. 1 t e
INSPECTION WORKSHEET FOR DATE: 10/11/2006 TIME: 7 :02AM PAGE: 42
SITE ADDRESS: 0740 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 018 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
wiring.
OWNER: HARLOW SPAAN, JEFF SORG, CONI MEYER, PHONE #: 503 - 63&4580
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: at 10/11/2006 Pour Time:
Code # Inspection Descr tiq6/Yv Confirm # Contact # M- sage ` ' Q3
280 Insulation 0/64-d 038016 -01 6003 6636 -4580 Y
Corrections /Comments /Instructions: /' "
I li V a vv , 5.k ,- �� . C..)` 1. ‘) @._
Cvt,e5k-q. La .
=∎ _ e c-
I UJ t ':--(k , CA_Ni d i tS ---- ..) ( A
w 41,..... A ,,.__e
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: V IA ■ Date: k. Phone #: (503) 718 -V" a
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200S -00153
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175 s 2� °1 'L.
INSPECTION WORKSHEET FOR DATE: 9/27/2006 TIME: 7 :07AM PAGE: 35
SITE ADDRESS: 5 SW CLASS OF WORK:
0740) JVt+' SE1tELAN RD CLAS
SUBDIVISION: HERMOSO PARK LOT #: 018 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
wiring.
OWNER: HARLOW SPAAN, JEFF SORG, CONI MEYER, PHONE #: 503 - 636 -4580
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 9/27/2Q05 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 037220 -01 503- 636 -4580 N
Corrections /Comments /Ins uct� <f
0 4' ,
I
gr_.A At '
I,j ° I.` 1 mi-
/A. .
a ti.,p_ ri. t.- T Z / .
Now ' ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ■ CALL FOR INSPECTION ❑ ADDITI NAL FE S ASSESSED
it/ I r a7 2-
Inspector: Date: Phone #: (503) 718- `
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST2006-00159 .
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639 -4171 r
Inspection Requests (24 Hrs.): (503) 639 -4175 .2' "'I I I ..
INSPECTION WORKSHEET FOR DATE: 9/18/2006 TIME: 7:01AM PAGE: 50
SITE ADDRESS: 07405 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: 016 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel. 8/15/06, adding low voltage for data
wiring.
OWNER: HARLOW SPAAN, JEFF SORT, CONI MEYER, PHONE #: 503 - 63&4580
CONTRACTOR: OWNER PHONE #:
Inspection Request Scheduled For: Date: 81/8/2006 Pour Time: 12
Code # Inspection Description Confirm # Contact # Message
205 Footing 036677 -01 503 - 636 -4580 N
Corrections /Comments /Instructions: ,�'+ /7
0 Ar/ .. 63 /L "6 n ' // ))Jo .#40',1-0‘4C l . p i2 141 �j4 t2rSZ,
•
PASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL CALL FOR INSPECTION El ADDITIONAL FEES ASSESSED
. /
Inspector: L- Date: v---/e--z Phone #: (503) 718-
r �
CITY OF TIGARD
BUILDING DIVISION PERMIT #: MST200&.001 �3
13125 SW Hall Blvd., Tigard, OR 97223 DATE ISSUED: 7/14/2006
Phone: (503) 639 -4171
Inspection Requests (24 Hrs.): (503) 639 -4175
INSPECTION WORKSHEET FOR DATE: 819/2006 TIME: 7:04AM PAGE: S'
SITE ADDRESS: 07406 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERtv9OSO PARK LOT #: 018 TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel.
OWNER:
ti 5 .
PHONE #: •` `.� .
HARLOW SPAAN, JEFF SORG, Rte 40NI MEYER, 503 -6.6 �,yt�t]
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 8/9/2006 Pour Time:
Code # Inspection Description Confirm # Contact # Message
276 Framing 034625-01 603 - 636-4500 N
Corrections /Comments/ Instructions:
MEI 1 41 • IA
i� rd "
- F ec_ c pm rr r
U� L
❑ PASS PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
I I FAIL CALL FOR INSPECTION ❑ ADDITIO AL F ES ASSESSED
Inspector:
Ni& Date: Phone #: (503) 718
1
CITY OF TIGARD
BUILDING DIVISION - -mint: mar200(� -001ai
13125 SW Hall Blvd., Tigard, OR 97223 / BATE ISSUED: 7/14/2006
Phone: (503) 639 -4171 f��
Inspection Requests (24 Hrs.): (503) 639 -4175 1 !. S ∎-J
INSPECTION WORKSHEET FOR DATE: 817/2006 TIME: 7:02AM PAGE: 30
SITE ADDRESS: 07405 SW BEVELAND RD CLASS OF WORK:
SUBDIVISION: HERMOSO PARK LOT #: p1Q TYPE OF USE:
PROJECT NAME: SPAAN
DESCRIPTION: Convert garage to habitable space and upper floor remodel.
OWNER: HARLOW SPAAN, JEFF SORG, CONI MEYER, PHONE #: 503. 636 -4688
CONTRACTOR: PHONE #:
Inspection Request Scheduled For: Date: 8/7/2006 Pour Time: 10 :00
Code # Inspection Description Confirm # Contact # Message
205 Footing 034483-01 603-636.4580 N ,
Corrections /Co ents /Instructions:
Z/C ?) 1 ? LQ . S
--- Crti■
ASS ❑ PARTIAL APPROVAL ❑ CANCEL ❑ NO ACCESS
❑ FAIL ❑ CALL FOR INSPECTION ❑ ADDITIONAL FEES ASSESSED
Inspector: \� C , �' 7 / a Date: Phone #: (503) 718- Z1/4-12'1